Question

The practice of using multiple CPT codes to maximize reimbursement is called?

a) Unbundling
b) Bundling
c) Stacking
d) Grouping

Answer 1

Using multiple CPT codes to maximize reimbursement is called unbundling, which is considered fraudulent and is monitored by insurance and regulatory entities.

Step-by-step explanation:

The practice of using multiple CPT codes to maximize reimbursement is known as unbundling. Unbundling refers to the use of multiple billing codes for procedures that normally are covered by a single comprehensive code. This deceptive practice can result in higher payments to the provider as it suggests that more complex or multiple services were performed. Unbundling is considered fraudulent in the healthcare industry and is closely monitored by insurance companies and regulatory entities.